What is Syphilis?

Syphilis is caused by a spirochete called Treponema pallidum. Syphilis can progress through four major stages, beginning 2 weeks to a month after infection.

Primary Syphilis

  • The first stage, or primary syphilis, is nearly always characterized by the appearance of a painless sore wherever the spirochete entered the body.
  • The sore, called a chancre, begins as a reddish bump that develops into a pimple. It then opens and ulcerates, often oozing pus until a scab develops.
  • The chancre is sometimes surrounded by a pink border. This sore is infested with the treponema organism, and the individual is highly infectious at this stage.
  • Usually the chancre appears on the genitals, although it can appear on the mouth, anal area, and on fingers or breasts.
  • In women it frequently occurs on the inner vaginal wall or cervix and sometimes in the rectum.
  • Since it is relatively painless, it may not be noticed.
  • Within 4 to 6 weeks, the chancre heals even without treatment and there may be no further symptoms for up to 6 months.

Secondary Syphilis

  • The next stage, secondary syphilis, usually begins with a bumpy skin rash, accompanied by general symptoms of illness such as fever, swollen lymph nodes of the neck, nausea, headache, sore throat, loss of scalp hair, and loss of appetite.
  • More moist sores may appear around the genitals or anal region.
  • Again, even without treatment, the symptoms eventually abate within a few weeks, and the disease enters its latent stage.
  • It is estimated that slightly more than half of untreated syphilis victims remain in the latent stage for the rest of their lives.

Tertiary Syphilis

  • People who progress to the tertiary syphilis stage usually face serious complications resulting from the spirochete infecting inner tissues and organs.
  • It may attack the heart, brain and spinal cord, eyes, joints, and numerous other areas, leading to life-threatening disease, blindness, psychosis, or paralysis.
  • Although modern medical treatment has greatly reduced the number of syphilis cases progressing to the tertiary stage, they still occur.
  • In later tertiary stages, the disease typically cannot be transmitted to others.


  • A blood test is used to determine if an individual is infected with syphilis.
  • Because the blood tests look for antibodies, these tests can be performed during any stage of infection.


  • An individual who test positive for syphilis is usually treated with penicillin.
  • For individuals allergic to penicillin, other antibiotics can be used.


  • Refraining from oral, anal or vaginal sex will prevent the risk of contracting syphilis.
  • If you are sexually active, having sex with only one uninfected partner will reduce your risk of contracting an infection.
  • Latex or polyurethane condoms can be used during oral, anal, and vaginal sex to also reduce the risk.
  • Condoms will not provide complete protection as syphilis can be transmitted through the open chancre which may be located in an area not covered by the condom.

Adapted from:

Sexual Health Sexually Transmitted Infections (STIs) Contraception